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Frequently Asked Questions.

Ketamine is an anesthetic medication that’s been FDA-approved for use in surgery since the 1970s. But pain relief is far from its only advantage. An ever-growing body of scientific research has proven that low-dose intravenous (IV) ketamine infusions can also have transformative effects on the brain that effectively “reboot” it to treat various mental health conditions including treatment-resistant depression, anxiety, and more.

Ketamine relaxes the mind and gives you a break from your cyclical thoughts and stories. But it also does a lot more. Traditional antidepressants work by blocking the reabsorption of brain chemicals like serotonin, norepinephrine, and dopamine to improve communication between brain cells. At low doses, ketamine, on the other hand, works on glutamate, the most common neurotransmitter, and its NMDA receptors, leading to increased production of brain proteins like BDNF. These proteins build new, stronger, healthier connections, or synapses, between brain cells, reversing the damage that chronic stress and depression do to the synapses. In other words, ketamine effectively reboots the brain, which reacquaints you with your foundation, values, and intentions.

Our current protocol is an initial series of six infusions over two to three weeks. Research shows that starting therapy with a series of six infusions results in longer lasting symptom reduction. However, we will customize the number of initial infusions based on clinical response and any feedback from your trusted mental health provider partners. We firmly believe in the importance of a team approach in individualizing patient care.

The reduction in depressive symptoms after the initial series lasts approximately five weeks, with a range of three weeks to two months noted for most people. Subsequent single maintenance (or “booster”) infusions may be necessary to sustain symptom improvement. Each patient is unique; these boosters may be indicated anytime from three weeks to three months after the initial series.

Studies show 48–72 hours between treatments is beneficial to facilitate integration and introspection after your inner exploration. You can do this post-treatment processing alone or with the support of a mental health care provider. Incorporating ketamine therapy into a holistic wellness plan including psychotherapy and other modalities can help prolong its effects. The hope is that over time you will need infusions less frequently and be able to stop treatment altogether.

Soft Reboot Wellness can partner with your existing mental health care provider to tailor the experience to your goals and facilitate ketamine-assisted psychotherapy. If you don’t already have a provider, we’ll invite our in-house specialist to meet with you and offer guidance.

Ketamine has been proven safe and effective over decades of widespread use. The drug has a minimal effect on breathing, blood pressure, or heart rate, making it an ideal anesthetic. It was first FDA-approved for anesthesia in 1970. The amount given during an infusion for mental health treatment is just a fraction of the dose safely used in sedation during surgery. But ketamine’s mental health applications are still considered “off-label” uses of the drug, meaning they are emerging treatments that the FDA hasn’t yet formally approved. Research on ketamine for depression and other mental health conditions is extensive and ongoing.

While the medication is extremely safe, there are recommended standards for administration. Therapy should be done by a licensed physician who can administer a DEA schedule III medication. ACLS certification is recommended as well as meeting the American Society of Anesthesiologists’ requirements for the delivery of moderate sedation. It is also recommended that the outpatient environment where these services are performed have the ability to monitor vitals signs every 15 minutes. Additionally, when patients have a pre-existing history of cardiovascular or respiratory problems, they may receive additional support and monitoring with oxygen therapy and continuous end-tidal CO2 monitoring during their infusions.

All of our treatments are administered and monitored by our founder, Harvard-trained board-certified anesthesiologist, Dr. Sara Herman. Dr. Herman has over 12 years of experience administering ketamine in operating room settings. She personally provides all clinical services related to the administration and monitoring of every client in her office. Each client is monitored safely and according to the above practice guideline and concordant with the medical records and information provided by the client.

Dr. Herman is a member of American Society of Ketamine Physicians and the Psychedelic Medicine Association.

She has an interest in altered states of consciousness, psychedelic medicine, and integrative health and wellness. Her practice is informed by scientific evidence, but balanced with your unique goals of care. Dr. Herman has set an intention to practice psychedelic medicine with ethics, integrity, and a commitment to her patients’ holistic wellness.

The side effects of IV ketamine are mild and depend on the dose and frequency of administration. Some patients don’t experience any side effects at all. Others may experience some nausea or anxiety during the infusion, which can be easily treated on the spot by our doctor. The most common side effects are mild headache, nausea, and fatigue for a few hours after the treatment. Ketamine infusions can also elevate blood pressure and heart rate during the treatment for some people, which is why it’s important to seek this therapy from a skilled and experienced physician. Our Harvard-trained board-certified anesthesiologist closely monitors vital signs throughout the infusion.

Chronic recreational ketamine users, who take much larger doses (100X–1,000X) than are necessary for therapeutic treatments, report severe side effects such as bladder cystitis, addiction, and cognitive impairment. But there are no known serious long-term side effects of low-dose ketamine therapy.

Ketamine experiences can vary from person to person and day to day. During the infusion, you won’t lose awareness of your surroundings, but you may feel like you’ve entered a dream or that things seem unreal. An out of body experience is common, and it may feel like you’re watching your mind and body from outside yourself. You could get a little drowsy or confused. You might notice changes in your energy level, vision, speech, or perception of time. Feeling off-balance or a little dizzy is common, but you’ll be relaxing in our cushy zero-gravity chair until that goes away. Cyclical thoughts, anxieties, or narratives you tell yourself can shift or temporarily dissolve. Your world may suddenly feel lighter. You may be overcome with feelings of euphoria, peace, or mysticism.

After the infusion, you could start feeling like yourself again in as little as 20 minutes. We will monitor you in the office until your vital signs return to baseline. For several hours, you may feel a little tired or foggy-headed. You may also experience headaches, nausea, and dizziness for one to three hours after the infusion. Plan for some downtime after your treatment. This may also be a good reason to schedule your infusion in the afternoon so that you can rest and rejuvenate from the evening onward.

Read more: How Does It Feel to Get Ketamine Therapy?

During your infusion, it’s important to remember that you are safe and under the care of a board-certified Harvard-trained anesthesiologist. You chose this therapy for its transformative effects. Powerful experiences lead to meaningful changes. Our goal is to expose you only to experiences you feel ready to handle. It’s counterproductive to push you into an overwhelming experience that will prevent you from exploring further. This treatment typically works best in a series of infusions. If the experience becomes too intense or uncomfortable, we will adjust your overall dose or slow down the rate of the infusion drip. This is what we call “titrating to effect.” And when you feel ready to challenge yourself, we can help you with that, too.

No. Some people may have heard of ketamine as a party drug under other names such as “Special K,” “Kit Kat,” or “Vitamin K.” However, ketamine has a wide safety margin in the hands of clinicians specially trained to administer the medication. The dose used for treatment of depression is much smaller than the dosages used in illicit settings, and it has been found that at these very low doses, in a medical setting, there is virtually no potential for addiction or abuse. In fact, low-dose ketamine infusion therapy can be helpful for patients struggling to recover from addiction to alcohol or drugs.

Before a drug can be approved, a pharmaceutical company must submit clinical data and other information to the Food and Drug Administration (FDA) for review. The company must show that the drug is safe and effective for its intended uses. “Safe” does not mean that the drug has no side effects. Instead, it means the FDA has determined the benefits of using the drug for a particular use outweigh the potential risks. Once a drug has been approved by the FDA for one purpose, healthcare providers may generally prescribe that drug for other purposes when they judge that it is medically appropriate for their patient. The practice of prescribing a drug for a purpose other than that for which it is approved is known as “off-label” use. Off-label use of medications is legal and common. In fact, about one in five prescriptions written in the US today is off-label.

Despite an ever-growing body of research supporting ketamine therapy for depression, anxiety, PTSD, OCD, and chronic pain, they remain off-label uses of the drug. Because ketamine has been administered for over 50 years as an anesthetic, its patent has expired, making it now a generic drug. Without a patent, there isn’t much potential for profit. That means there’s no financial incentive for any pharmaceutical company to sponsor the kind of large costly clinical trials of ketamine for mood and pain disorders that are required for FDA approval.

Unless your provider closely follows the latest research, they may not be aware of the evidence supporting ketamine’s success in treating mental health and pain conditions. During medical school, they likely only learned about the drug as an anesthetic. And if they have heard about the drug’s off-label uses, they may still have their own opinions and biases against innovation or “psychedelics.” Or they may know all about it and be excited about its potential but not know where to refer you for treatment.

Psychedelic medicine describes the practice of using psychoactive substances that produce changes in perception, mood, and cognitive processes for therapeutic purposes. Scientific research has shown that psychedelics can promote mental health and wellbeing partially by relaxing the mind and the ego, temporarily stopping cyclical thoughts, and giving the patient a glimpse at a different perspective. When used with intention as part of an individualized holistic wellness plan, psychedelics can effectively reboot the brain and open the window to transformation.

Ketamine can help with the following:

  • Depression
  • Anxiety
  • PTSD
  • OCD
  • Postpartum mental health
  • Premenstrual dysphoric disorder (PMDD)
  • Personal/spiritual growth
  • Burnout
  • Chronic pain conditions
  • CRPS
  • Migraines
  • Fibromyalgia

We carefully screen all patients to ensure they’re good candidates for ketamine therapy before working together with their current provider or our in-house psychiatrist to design an individualized treatment plan. Some of the conditions that could exclude you from treatment include:

  • Pregnancy or breastfeeding
  • Psychosis, schizophrenia, personality disorders
  • Uncontrolled Hypertension
  • Ketamine allergy
  • Recent traumatic brain injury
  • Bladder and/or urinary issues

On the day of your infusion, we examine you before treatment and reserve the right to cancel your ketamine therapy if you arrive with:

  • severely high blood pressure
  • chest pain
  • evidence of drug use (cocaine, amphetamines, or opiates)
  • manic symptoms

IV ketamine therapy uses ketamine, an anesthetic that’s been FDA-approved for use in surgery since the 1970s. The nasal spray contains esketamine, a drug approved by the FDA in March 2019 under the brand name Spravato. The two drugs are closely related. Ketamine is a generic drug. Esketamine is a slightly different form of ketamine which allowed it to be patented and monetized as a novel treatment for depression.

So far, it seems the two forms of the drug work similarly to treat depression and other mental health conditions. And the experience is pretty similar for the patient. Just as with an IV ketamine infusion, patients are required to take the nasal spray in a healthcare clinic under supervised care and to have a designated driver present for discharge from the treatment. The potential side effects of the two drugs are also similar.

The only benefit of the nasal spray is that it doesn’t require a needle poke in the arm. But it only comes in two doses—low and high. Whereas IV administration of ketamine allows the physician to tailor the dose to the patients’ individual needs, based on weight and treatment goals, and to adjust the dose and rate of the drip during the treatment as necessary. IV delivery is also the most effective method for absorption and accuracy of dose.

We do not require a referral. We ask you to start by filling out our short intake questionnaire and speaking with our patient care coordinator before scheduling your consultation with Dr. Herman. These steps help us ensure ketamine therapy will be a beneficial step in your personal wellness journey and give us the information we need to work with your current health care provider to design an individualized treatment plan. If you’re currently working with a mental health professional, PCP, or other referring physician, we’ll request the release of your medical records. If you do not have a current provider, we can refer you to one. While there are minimal risks with ketamine treatment, we value a team approach to medicine and require that you remain under the care of another medical or mental health professional through the course of treatment.

You’ll start with a consultation, where we’ll go over your treatment journey and all necessary preparation in detail. The success of psychedelic medicine depends largely on “set,” or your mindset going into the treatment, and “setting,” the environment where the therapy takes place. We take care of the setting, but there are a few key steps for you to take prior to treatment that will prime your mindset for the experience.

Then to crystallize the therapy’s transformative effects, it’s vital to take intentional steps after your treatment to digest, embody, and integrate the insights and discoveries from your inner exploration into your daily life.

Read more about what to expect on your ketamine journey.

You want to use your insurance. We get it. We would too. But like a lot of physicians, we’ve decided not to take insurance, because we want to be able to make treatment decisions based on what will best serve each individual patient—not what their insurers will cover. Payment is collected at the time of treatment. And we’ll provide a superbill that you can submit to your insurance for reimbursement. Unless your insurer is Medicare. We are opting out of Medicare, because their rules and regulations can interfere with our providing the best possible care. For treatment at Soft Reboot Wellness, you will sign an agreement not to submit treatment claims to Medicare for reimbursement.

Currently, we accept cash, ACH transfer, credit cards, debit cards, and HSA or FSA accounts. An FSA or HSA is a great way to utilize money from your paycheck, that is put into a specific account for healthcare expenditures before taxes are taken out. In other words, instead of paying for ketamine treatments with “after tax” dollars, you’re using “pre-tax” dollars to pay for ketamine treatments, which will give most people about a 40 percent discount.

After we treat you, we provide a superbill. You can use the Osmind app to submit an out-of-network claim to your insurance company for reimbursement. All you need is the superbill and about two minutes to input information into the app. Osmind takes care of the rest, rapidly sending your claim digitally to your insurance company. The insurance company confirms that it has received your claim, and you will receive your Explanation of Benefits letter with your reimbursement directly from your insurance company. The Osmind app makes it very easy for you to submit your insurance claims, significantly speeds up the reimbursement process, and increases the chance of a successful reimbursement. If your claim is rejected, Osmind also offers a rejection resolution pathway. For any questions or assistance with claims, email support@osmind.org.

The Osmind app lets us stay in touch between treatments and makes your care more efficient. Keeping tabs on your progress throughout your treatment with the app and its symptom rating scales lets us individualize your care and help you feel better faster. Research backs this up. Your self-tracking keeps us apprised of your mood and also allows us to intervene before a relapse.

The Osmind Community is a safe space for people with treatment-resistant depression and related mental health conditions to connect with others. You’ll find support, positivity, and empathy through the forum and chat. It is also a place for people who are interested in innovative treatments such as psychedelic medicine (including ketamine, esketamine, MDMA, psilocybin, and more) and neuromodulation to discover and share information. Members pool their strength, perspectives, experiences, and knowledge.

To get started, download the mobile app. On the iPhone, click this link to download the app (alternatively, search “Osmind” in the App Store). For Android users, click this link to download the app (or search “Osmind” in the Google Play Store). After you download the app, you can log in using the temporary credentials included in your invitation email. You can also click “Forgot Password” to reset your password.

Yes! The platform is HIPAA-compliant, protected by end-to-end encryption, and research-grade (meaning parties such as the FDA trust the authenticity of the data). Our clinic and Osmind both uphold strict standards for safeguarding protected health information that meet or exceed legal requirements. Osmind works with independent third parties to verify its compliance and security. We chose to use this system because we trust its security and privacy safeguards.